COMPARISON OF POSTOPERATIVE ANALGESIC EFFICACY BETWEEN ULTRASOUND-GUIDED BILATERAL EXTERNAL OBLIQUE INTERCOSTAL PLANE BLOCK AND BILATERAL TRANSVERSE ABDOMINIS PLANE (TAP) BLOCK IN LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background:
Laparoscopic cholecystectomy is frequently associated with moderate postoperative pain. Regional blocks, such as the transversus abdominis plane (TAP) block, are commonly used to mitigate pain. The external oblique intercostal (EOIC) block is a newer technique targeting upper abdominal wall analgesia.

Objective:
To compare the efficacy of ultrasound-guided bilateral EOIC block versus TAP block in patients undergoing laparoscopic cholecystectomy under general anaesthesia.

Methods:
A double-blind, prospective observational study was conducted on 60 patients (ASA I–II, aged 18–60 years) undergoing laparoscopic cholecystectomy. Patients were randomized to receive either bilateral EOIC block (Group E) or TAP block (Group T) using 30 ml of 0.125% levobupivacaine with 4 mg dexamethasone. VAS scores at rest and movement were recorded at multiple time intervals postoperatively. The time to first rescue analgesia, number of doses, and percentage of patients requiring rescue analgesia were evaluated.

Results:
Group T showed significantly lower VAS scores at rest and movement in the first 4 postoperative hours (p<0.001). Group T had a longer duration to first rescue analgesia (10 ± 8.35 hrs vs 7.33 ± 9.40 hrs, p<0.0001) and required fewer rescue doses (0.5 ± 0.68 vs 1.8 ± 1.47, p<0.0001). Fewer patients required rescue analgesia in Group T (40% vs 76.6%, p=0.0051).

Conclusion:
Ultrasound-guided TAP block provided superior postoperative analgesia compared to EOIC block for laparoscopic cholecystectomy.